title: Regional differences in disability retirement: explaining between-county differences in Finland.
abstract: OBJECTIVE
  This study aimed to examine between-county differences in disability retirement due to main diagnosis groups and explain these differences by individual-level demographic and work-related factors and municipality-level characteristics.
  
  
  METHODS
  A 20% random sample of the Finnish social insured population aged 25-62 years at the end of 2006 was followed for disability retirement until the end of 2011. Individual-level demographic and work-related covariates were derived from the registers of the Finnish Centre for Pensions and complemented by municipality-level covariates from the national SotkaNet databank. Standardized disability retirement rates were calculated and logistic regression analysis was used to examine between-county differences during the 5-year follow-up.
  
  
  RESULTS
  In the county with the highest incidence, disability retirement was nearly twice as common as in the county with the lowest incidence. The between-county differences were larger in disability retirement due to cardiovascular and musculoskeletal diseases than other causes. Adjusting for demographic and work-related characteristics explained a third of the differences. Further adjustment for municipal characteristics explained up to 60% of the differences. However, in regions of Northern and Eastern Finland with the highest incidence of disability retirement, 20-30% excess incidence remained even after all adjustments.
  
  
  CONCLUSIONS
  Large differences exist in disability retirement between Finnish counties. Disability retirement due to musculoskeletal diseases has the highest impact on the overall differences. Demographic structure and work-related characteristics but also municipality-level characteristics contribute to these differences.
authors.affiliation: Finnish Centre for Pensions, FI-00065 Eläketurvakeskus, Helsinki, Finland. mikko.laaksonen@etk.fi.
authors.forename: Mikko
authors.initials: M
authors.lastname: Laaksonen
authors.forename: Raija
authors.initials: R
authors.lastname: Gould
mesh_terms: D000328:Adult; D006233:Persons with Disabilities; D005387:Finland; D006801:Humans; D008875:Middle Aged; D010415:Pensions; D012179:Retirement